Diaphragmatic thickness in chronic obstructive lung disease and relationship with clinical severity parameters

Conclusion: Diaphragmatic dysfunction in COPD is related to mobility restriction rather than muscle thickness

An underestimated comorbidity of COPD: Thyroid dysfunction

Chronic obstructive pulmonary disease (COPD) has many systemic effects influencing morbidity and mortality of the disease. Thyroid diseases which are more common in COPD patients than who do not have COPD are underestimated despite important clinical consequences. Similar to general population, thyroid dysfunctions are more common in females than males among COPD patients. Both hypothyroidism and hyperthyroidism may be associated to COPD. As well as systemic inflammation hypoxia, age, glucocorticoid use and smoking are some of the effective factors on developing thyroid dysfunction in COPD patients. In this article thyroid dysfunctions that are underrecognized comorbidities of COPD patients, their mechanisms of action and clinical outcomes were reviewed

Chronic obstructive pulmonary disease phenotypes: Are they really useful in clinical practice?

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. It is a complex and heterogeneous disease. In recent years, studies showed that forced expiratory volume in 1 s solely was not enough to describe heterogeneity of COPD patients, and subsequently, phenotypes of COPD were identified. The aim of phenotyping is the classification of patients into distinct subgroups according to the prognosis and response to therapy so that the selection of optimal therapy can be possible, and this clinical approach may improve prognosis. In the assessment and management of the disease, it is important to consider phenotype of a COPD patient. The aim of this article is to review predefined COPD phenotypes, their clinical and epidemiological features, and usefulness in clinical practice for accurate diagnosis and appropriate treatment of COPD patients

Rarely occurrance of two diffuse idiopathic neuroendocrine cell hyperplasia cases

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare disease which needs a long time for diagnosis and usually defined by case reports and small series. We reported two cases, one with 67 and the other with 66-years-old, both of them were female. They presented with long-lasting complaints of cough and shortness of breath. Computed tomography of patients showed multiple nodules on the basis of lungs, and additionally, mosaic perfusion was seen in the first case. Tissue samples were taken with video-assisted thoracic surgery, and the patients were diagnosed with DIPNECH by immunohistochemical examination. We wanted to emphasize the importance of DIPNECH which is a rare clinical entity causing chronic respiratory symptoms which should be considered in differential diagnosis of multiple pulmonary nodules

Does thromboprophylaxis prevent venous thromboembolism after major orthopedic surgery?

OBJECTIVE: Pulmonary embolism (PE) is an important complication of major orthopedic surgery. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE) and factors influencing the development of VTE in patients undergoing major orthopedic surgery in a university hospital. METHODS: Patients who underwent major orthopedic surgery (hip arthroplasty, knee arthroplasty, or femur fracture repair) between February of 2006 and June of 2012 were retrospectively included in the study. The incidences of PE and deep vein thrombosis (DVT) were evaluated, as were the factors influencing their development, such as type of operation, age, and comorbidities. RESULTS: We reviewed the medical records of 1,306 patients. The proportions of knee arthroplasty, hip arthroplasty, and femur fracture repair were 63.4%, 29.9%, and 6.7%, respectively. The cumulative incidence of PE and DVT in patients undergoing major orthopedic surgery was 1.99% and 2.22%, respectively. Most of the patients presented with PE and DVT (61.5% and 72.4%, respectively) within the first 72 h after surgery. Patients undergoing femur fracture repair, those aged ≥ 65 years, and bedridden patients were at a higher risk for developing VTE. CONCLUSIONS: Our results show that VTE was a significant complication of major orthopedic surgery, despite the use of thromboprophylaxis. Clinicians should be aware of VTE, especially during the perioperative period and in bedridden, elderly patients (≥ 65 years of age)

Does thromboprophylaxis prevent venous thromboembolism after major orthopedic surgery?

OBJECTIVE: Pulmonary embolism (PE) is an important complication of major orthopedic surgery. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE) and factors influencing the development of VTE in patients undergoing major orthopedic surgery in a university hospital. METHODS: Patients who underwent major orthopedic surgery (hip arthroplasty, knee arthroplasty, or femur fracture repair) between February of 2006 and June of 2012 were retrospectively included in the study. The incidences of PE and deep vein thrombosis (DVT) were evaluated, as were the factors influencing their development, such as type of operation, age, and comorbidities. RESULTS: We reviewed the medical records of 1,306 patients. The proportions of knee arthroplasty, hip arthroplasty, and femur fracture repair were 63.4%, 29.9%, and 6.7%, respectively. The cumulative incidence of PE and DVT in patients undergoing major orthopedic surgery was 1.99% and 2.22%, respectively. Most of the patients presented with PE and DVT (61.5% and 72.4%, respectively) within the first 72 h after surgery. Patients undergoing femur fracture repair, those aged ≥ 65 years, and bedridden patients were at a higher risk for developing VTE. CONCLUSIONS: Our results show that VTE was a significant complication of major orthopedic surgery, despite the use of thromboprophylaxis. Clinicians should be aware of VTE, especially during the perioperative period and in bedridden, elderly patients (≥ 65 years of age)

The incidence of polyneuropthy and its relation with disease parameters in chronic obstructive pulmonary disease

Objective: Chronic Obstructive Pulmonary Disease (COPD) is accompanied by several concomitant conditionsdue to its systemic effects. Hypoxia and oxidative stress associated with COPD are also believed to contributeto the disease course through the effects of several inflammatory mediators. Major causative agents causing ofperipheral neuropathy are age, hypoxia, duration and severity of COPD, hypercapnia and smoking. The presentstudy aimed to investigate the incidence of polyneuropathy and its relation with disease parameters in COPDpatients.Methods: Of a total number of 45 patients who had been followed up between January 1, 2015 and December31, 2016 with a diagnosis of COPD at Ufuk University School of Medicine were enrolled retrospectively. Allpatients underwent electroneuromyography, arterial blood gas measurements and pulmonary function tests.Patients were divided as those with or without neuropathy, and factors contributing to the development ofneuropathy were investigated based on clinical and laboratory findings.Results: Eleven (24.4%) patients were women and 34 (74.6%) were men, and the mean age was 73.2 years.Mean PaO2 was 58.2 mmHg, pCO2 was 41.2 mmHg, and FEV1 was 45.3%. Neuropathy was diagnosed intwenty (44.4%) patients. Significant differences were found in pO2, pCO2, SO2, mMRC, smoking status andnumber of exacerbations per year (p < 0.05).Conclusions: Patients who experience frequent exacerbations and those with hypoxemia or hypercapnia asdemonstrated should be taken into more careful clinical assessments with respect to polyneuropathy

The incidence of polyneuropthy and its relation with disease parameters in chronic obstructive pulmonary disease

Objective: Chronic Obstructive Pulmonary Disease (COPD) is accompanied by several concomitant conditionsdue to its systemic effects. Hypoxia and oxidative stress associated with COPD are also believed to contributeto the disease course through the effects of several inflammatory mediators. Major causative agents causing ofperipheral neuropathy are age, hypoxia, duration and severity of COPD, hypercapnia and smoking. The presentstudy aimed to investigate the incidence of polyneuropathy and its relation with disease parameters in COPDpatients.Methods: Of a total number of 45 patients who had been followed up between January 1, 2015 and December31, 2016 with a diagnosis of COPD at Ufuk University School of Medicine were enrolled retrospectively. Allpatients underwent electroneuromyography, arterial blood gas measurements and pulmonary function tests.Patients were divided as those with or without neuropathy, and factors contributing to the development ofneuropathy were investigated based on clinical and laboratory findings.Results: Eleven (24.4%) patients were women and 34 (74.6%) were men, and the mean age was 73.2 years.Mean PaO2 was 58.2 mmHg, pCO2 was 41.2 mmHg, and FEV1 was 45.3%. Neuropathy was diagnosed intwenty (44.4%) patients. Significant differences were found in pO2, pCO2, SO2, mMRC, smoking status andnumber of exacerbations per year (p < 0.05).Conclusions: Patients who experience frequent exacerbations and those with hypoxemia or hypercapnia asdemonstrated should be taken into more careful clinical assessments with respect to polyneuropathy